title: [Coronary artery fistulas, a current problem: Clinical and therapeutic considerations].
abstract: The coronary fistula is a link between one or more of the coronary arteries and cardiac cavity or great vessel. The exact occurrence is unknown. The majority of these fistulas are congenital in origin. However, they may occasionally be detected after cardiac surgery. For a long time, fistulas are asymptomatic, especially if they are small; the frequency of the symptoms and especially the complications rise with age. The potential complications are: cardiac failure, endocarditis, endarteritis, atrial fibrillation, ventricular arrhythmias, rupture, and thrombosis. The main differential diagnosis is patent arterial duct, while other congenital arteriovenous shunts need to be excluded. Even though echocardiography Doppler can help to differentiate shunts, the coronary angiography remains the main diagnostic tool for the description of the anatomy. For a long time, the surgery was the only therapeutic means, up till now, percutaneous occlusion is the first line therapy of coronary fistulas and that the different devices can be tailored to meet different anatomic and functional characteristics.
authors.affiliation: Service de cardiologie, centre hospitalier Laennec, 60100 Creil, France. Electronic address: alberto.tiritilli@ch-creil.fr.
authors.forename: A
authors.initials: A
authors.lastname: Tiritilli
authors.affiliation: Service de cardiologie, centre hospitalier Laennec, 60100 Creil, France.
authors.forename: P
authors.initials: P
authors.lastname: Iaria
authors.affiliation: Service de cardiologie, centre hospitalier Laennec, 60100 Creil, France.
authors.forename: P
authors.initials: P
authors.lastname: Viard
authors.affiliation: Service de cardiologie, centre hospitalier Laennec, 60100 Creil, France.
authors.forename: S
authors.initials: S
authors.lastname: Sayah
authors.affiliation: Service de cardiologie, centre hospitalier Laennec, 60100 Creil, France.
authors.forename: T
authors.initials: T
authors.lastname: Benali
authors.affiliation: Service de cardiologie, centre hospitalier Laennec, 60100 Creil, France.
authors.forename: J-P
authors.initials: JP
authors.lastname: Detienne
authors.affiliation: Service de cardiologie, centre hospitalier Laennec, 60100 Creil, France.
authors.forename: S
authors.initials: S
authors.lastname: Martis
authors.affiliation: Service de cardiologie, centre hospitalier Laennec, 60100 Creil, France.
authors.forename: F
authors.initials: F
authors.lastname: Tchatchum
authors.affiliation: Service de cardiologie, centre hospitalier Laennec, 60100 Creil, France.
authors.forename: P
authors.initials: P
authors.lastname: Aouate
mesh_terms: D000328:Adult; D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D001919:Bradycardia / Q000209:etiology; D002637:Chest Pain / Q000209:etiology; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging* / Q000628:therapy*; D023921:Coronary Stenosis / Q000209:etiology / Q000628:therapy; D004562:Electrocardiography; D005260:Female; D005402:Fistula / Q000000981:diagnostic imaging* / Q000628:therapy*; D006801:Humans; D008297:Male; D015607:Stents
keywords: Congenital; Coronary fistulas; Fermeture percutanée; Fistules coronaires congénitales; Percutaneous closure